This article was originally written for publication in the
Homeopath, the Journal of the Society of Homeopaths. Although it was accepted
for publication by the Editor he was subsequently ordered not to publish it
by the board.

Professionalism by Peter
Fraser

Professionalism is environmental.
Amateurism is anti-environmental. Professionalism merges the individual into
patterns of total environment. Amateurism seeks the development of the total
awareness of the individual and the critical awareness of the groundrules of
society. The amateur can afford to lose. The professional tends to classify
and to specialize, to accept uncritically the groundrules of the environment.
The groundrules provided by the mass response of his colleagues serve as a pervasive
environment of which he is contentedly unaware. The "expert" is the man who
stays put.

Marshall McLuhan in
The Medium is the Massage

In recent years there has been a
substantial movement towards developing and establishing standards of professionalism
for lay homopaths who would now like to be referred to as "professional homopaths".
This movement has been spearheaded by the Society of Homeopaths, but it has
been an objective of almost all the organizations, schools and individuals involved
in homopathy. It pervades all aspects of modern homopathy, including registration,
supervision, education and research. However, the idea that professionalism
only enhances homopathy seems to have been accepted by organizations and individuals
without any sort of critical examination.

There are three aspects to be looked
at in evaluating an activity such as the pursuit of professional recognition.
The first is what is to be gained; the second is the chance of success and the
third is what has to be sacrificed.

The first of these aspects is the
pretty obvious advantages of professional status and the financial rewards that
professional status gives to those that have it. If homopaths are regarded
as medical professionals they will have the respect given to doctors and will
be able to earn substantial fees from the NHS and from private health insurers.
Even though many health professionals are not as well paid nor respected as
they should be and the NHS might be close to complete collapse, there is still
much to be said for this. A decent income and acknowledgment of our skills and
dedication are not to be sneezed at.

The second aspect is more variable
and depends on the other two. Small sacrifices are often worthwhile and if the
rewards are great or the chance of success is high then even large sacrifices
need to be considered. The reversibility of these sacrifices is also an important
consideration. In our situation the chance of reversing things, of moving back
from the strictures of state regulation to the freedoms of common law rights,
is virtually non-existent: the sacrifices we make are permanent and even if
we gain nothing from them we still pay the cost.

The chances of success in achieving
status and financial advantages are not great. Homopathy is based on a completely
different paradigm from conventional science. We are not going to be able to
change the structures of knowledge and thinking that underpin the worlds of
science, commerce and government. Yet without such change it is not possible
for homopathy to be truly accepted, let alone respected. The overwhelming view
of homopaths held by those with power is, at best, one of well meaning new
age kooks peddling expensive placebo. There are individuals who have been convinced
and many more that are happy to be polite when it costs nothing, but this does
not alter the distrust and disbelief that is the norm. Financially homopathy
appears to have little to offer the medical industrial complex, there are no
great profits for anyone, no patents to be had, and no showy statistics to offer
an electorate. Both our way of working and our results are energetic and subtle.

The most important factor to be considered
however, is undoubtedly the third, the sacrifices that homopathy will have
to make in order to achieve professional status. These sacrifices have not been
carefully examined, yet they are already being made.

Just as homopathy is subtle and
employs the minimum dose, so many of these changes are subtle and of minimum
apparent importance yet the effect can be enormous and felt throughout the practice
of homopathy.

An example of this is the diphthong.
Homopathy is a discipline built on its own history and an understanding of
its past. The language we use, like the common language we observe in our patients,
has meaning and significance. We are an archaic science, we build on our past
without the need to destroy it. This is our strength and connections to our
history are valuable. The need to be modern, to appear not to be archaic, means
not only that organizations have accepted the incorrect spelling but they have
forced it upon others. The use of the diphthong will have been removed from
this article and in the last Homeopath even the spelling of the title of Julian
Winston's book was changed in his letter on the subject. In a profession diversity
is unacceptable and uniformity is forced on all its members. The diphthong is
a small sign of the way pressures to be modern and scientific are forced on
us at the expense of our philosophy and effectiveness.

A more obviously important example
is vaccination. The Society currently espouses a very noncommittal stance that
in no way reflects the opinion of the overwhelming majority of its members.
The argument goes that only if we accept vaccination, and probably only if we
support it, will homopathy be accepted into the fold of professional medicine.
I am sure that I am not the only person who finds this tactic hypocritical and
distasteful. It also brings into question what other views will need to be suppressed.
The whole philosophy of homopathy is directly opposed to many aspects of conventional
medicine. What is the future for principles such as suppression, holism and
Hering's Laws which do not fit the current medical model?

The principles of homopathy have
also been forced into retreat in the Society's register. Where once they had
pride of place on the back cover they have been replaced by a commercial advertisement
that uses the images of allopathic medicines and money. The principles are relegated
to the inside, they are not enforced and are now threatened with removal. That
this is happening now is not a coincidence but the direct result of the move
towards professionalism. A profession needs to have a single well defined structure,
it cannot accommodate a variety of different or opposing views. The result is
that such a structure will be built around a level of mediocrity. It is not
practical to demand standards that are not acceptable to virtually all practitioners.
The problem is that a profession takes responsibility for all its members. At
the moment it is possible to say that anybody can practise and some who do are
not very good, each homopath is judged on his or her own merit. In a professionally
registered situation the entire profession is judged as a whole and the reputation
of that whole is gauged by the effectiveness of its weakest members. The problems
in public confidence being experienced by the medical profession come not from
the thousands of brilliant surgeons and physicians but from the handful of Ledwards
and Shipmans.

The oft cited reason why homopaths
need to be regulated and controlled is for public safety. Although homopathic
remedies can do harm, it is not easy to do so and it is not something that conventional
medicine admits anyway. We are not in the position of bodyworkers or acupuncturists
who can cause physical damage, or of TCM practitioners and herbalists who use
potentially toxic agents. The argument goes that incompetent practitioners will
not identify diseases and will not send patients for conventional treatment
until it is too late. Some homopaths want to act as primary carers for their
patients and feel that they are in a position to decide when others should be
consulted. One of the main arguments for professional registration is that it
will show homopaths are competent to do this. This is totally unnecessary because
in our culture we are not the sole primary carers. All my patients have at the
very least a GP, most have a psychotherapist, several consultants and several
other alternative practitioners as well. In a society with public healthcare,
homopaths do not need to take on non-homopathic roles. It is also ridiculous
to believe that the trivial amount of conventional medicine taught to homopaths
is adequate for the role of primary carer. If a person would like the role of
primary conventional practitioner as well as that of homopath they should do
the proper seven odd years of training and get the qualification. If by moving
down the path of professionalization we are saying that we claim this role,
future authorities will be perfectly justified in demanding that homopaths
gain full medical qualifications first.

As Marshall McLuhan points out there
are substantial differences between amateur and professional approaches. The
word amateur has connotations of inferiority and a lack of commitment but in
this context it is being used as the antithesis to professional. It encompasses
the concepts of unstructured as opposed to structured, individual as opposed
to uniform, general as opposed to specialized and critical as opposed to conforming.

A professional structure has enormous
constraints on it. "The amateur can afford to lose"; a profession cannot. The
amateur can make mistakes but a profession, as a whole, cannot. As individuals
will always make mistakes, a profession has to be structured so mistakes will
be minimized. This involves specialization, so that the professional will know
as much as possible, even if it is about a restricted field. It also involves
tactics that have the least chance of failure, even if the chances of exceptional
success are also limited.

This is not how classical homopathy
works. Classical homopaths are generalists, they take a holistic view of their
patients and need to be able to understand all aspects of disease, physical
and emotional. Even the most experienced practitioner cannot guarantee that
he or she can choose the right remedy. In conventional medicine there are protocols
to follow in every situation and following them will on the whole bring the
best chance of success. To do this with homopathy you cannot use a classical
approach, protocols can only be used with a practical approach where specific
remedies are indicated for specific diseases. This is why professional homopathy
eventually becomes practical, or even allopathic, and this is why the principles
have disappeared from the back of the register.

The way in which homopathy is moving
away from the classical model has been noted by many people. The issues of materia
medica and philosophy were both raised in the last issue of the Homeopath. In
these areas syntheses that are professional, acceptable, interpreted and secondary
are replacing an individual interpretation from first principles, primary sources
and raw data. Many, though not all, recognize that this is ultimately bad for
homopathy; few however, recognize that this is an unavoidable consequence of
a move towards professionalization.

Research, education and supervision
are similarly affected. Professional research has to be absolutely certain.
Double blind and placebo controlled techniques have to be used to achieve this
certainty. These techniques provide that certainty but they lose the information
that is not distinct enough to prove with certainty. A professional approach
to proving remedies will produce all those symptoms that are definitely part
of the proving picture but they will fail to produce a far greater number which
might be. These possible symptoms can be used in a holistic approach where anomalies
will stand out, they cannot be used in a protocol based system. A professional
approach that will only accept information from conventionally designed trials
is already permeating homopathy and truly useful information, which may come
from diverse sources and disciplines with varying degrees of reliability, is
deemed unacceptable. In education, professional homopaths must learn from a
structured and restrictive plan and they must all learn all of the things that
are taught. It is no longer acceptable to teach things that some students might
never fully comprehend and it is not acceptable for students to push themselves
and sometimes to fail. In supervision a simplistic model based on that used
in psychotherapy has been adopted because it is safe and straightforward. The
homopathic model would be far more complicated and might sometimes go wrong.
In all these areas certainty and mediocrity have replaced risk and the possibility
of genius.

The strengths of homopathy lie in
those things that are the antithesis to professionalism: individuality, archaism,
holism, risk-taking, generalism, understanding and awareness. To professionalize
it is to treat it allopathically and so to cause serious damage. To treat it
homopathically is to amateurize it. This may not sound very nice, but we should
remember that the remedies we give are precisely those things that are poisonous
in the hands of others.